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Home My WebLink About2790 MADISON ST; ; CB161165; PermitCity of Carlsbad 1635 Faraday Av Carlsbad, CA 92008 Plumbing/Mechanical/Electrical (PME) Permit 03-25-2016 Permit No: CB161165 Building Inspection Request Line (760) 602-2725 Job Address: Permit Type: Parcel No: Reference #: PC#: Project Title: 2790 MADISON ST CBAD PME 2031102700 4 PLEX-REPAIR GAS LINE FROM Status: Lot#: 0 Applied: Entered By: Plan Approved: Issued: Inspect Area: THE METER TO THE WATER HEATER Applicant: SCANLON FAMILY TRUST 12-18-90 C/0 MR&MRS JAMES SCANLON 7306 BORLA PL CARLSBAD CA 92009 760 889-4343 Plumbing Fees Electrical Fees Mechanical Fees Other PME Fees TOTAL PERMIT FEES Owner: SCANLON FAMILY TRUST 12-18-90 C/0 MR&MRS JAMES SCANLON 7306 BORLA PL CARLSBAD CA 92009 ISSUED 03/25/2016 RMA 03/25/2016 03/25/2016 $163.00 $0.00 $0.00 $0.00 $163.00 Total Fees: $163.00 Total Payments To Date: $163.00 Balance Due: Inspector: ~ Date: ~ Clearance: $0.00 NOTICE: Rease take NOTICE Iha 'W"C>/a d )OJ prqe:i irdL.des tte ""lrrpositiorl' d fees, decicaicrs, -= er clmr exa::ticns -cdledivay referred to as "fees/exa::ticns" Yoo rave 00 cia,,. Iran tte date ttis pemit""" isae:I to p,ctest irrpositioo d ttese feeslexa::ticns. If )OJ prdest 1ta1\ )OJ ITUSl fdlootte prctest ;:ro:eci.res set forth in G:MmTert Code Sedion 60020(a), a"d file tte prctest a"d any ctmr raµroo irtamiioo wth tte aty ~ for ~rg i,, ax:ada a, \Mth Qrlsboo M.ridpa Code Sedioo 3.32.cro. Faltre to tirray fdlootret ~ wll ta" any SLblecµrt lega noo to attad<, reJiew, set aside, vcid, a cJTlj tt-eir ifll'.)OOitia,. Yoo aa l"eeby FLRTI-ER NOTIFIED that )OJ ri[tt 1D prdest tte specified fees'exa::ticns IXES NOf !'PA. Y 1DIM'lla-a"d-.., a,nedia, fees a"d ~ c:tmges, ncr plmrg zmrg gmrgcrctmrsmla-applic:aioo ~rg crSS\licefees ina,nedia,wth ths prqoo. I\CRIXES IT APPLYroany i . ·1 lirri i THE FOLLOWING APPROVALS REQUIRED PRIOR TO PERMIT ISSUANCE: □PLANNING □ENGINEERING □BUILDING □FIRE □HEALTH 0HAZMATIAPCD {'city of Building Permit Application Plan Check No. 1,.1 IL I /, (! /., r~ 1635 Faraday Ave., Carlsbad, CA 92008 Est. Value 1./v . - Carlsbad Ph: 760-602-2719 Fax: 760-602-8558 n Plan Ck. _Depos t email: building@carlsbadca.gov ~ www.car1sbadca.gov -oate7 12,; I r jSWPPP JO~D'1~0 ~Qr\~ ~.-,. (A ~ '\, C c..-\.~\J SUITEI/SPACEf/UNIT# IAPN --- CT/PROJECT# !LOT# I PHASE# I# OF UNITS I# BEDROOMS # BATHROOMS I TENANT BUSINESS NAME I CONSTR. TYPE I OCC. GROUP DESCRIPTION OF WORK: Include Square Feet of Affected Are,) ('.,, o.. s l ; k. e V' e ..J c,_ : "' J " o IA,., \AA e, \ e -r-\-n w "-trr "'-~~{€'(' • EXISTING USE I PROPOSED USE I GARAGE (SF) PATIOS (SF) I DECKS (SF) FIREPLACE I IAIR CONDITIONING j FIRE SPRINKLERS v,so,_ "'° YES □No □ YES□No□ APPLICANT NAME PROPERTYOWNEK.\ \ lA A s, c.. 0.1,\. ~!A Primary Contact ADDRESS ADDREST\ ~ 7'I C, ~o~[c;._ V' kc.e.. CITY STATE ZIP CITYGi v-l ~ [,, <.. J ·c.A... of'\: ... 0 6 K' PHONE IFAX \"G',". '6 g/1-'-/ 3 i 3 I FAX EMAIL EMAi~ ~ f o c.:c-1 v-u. lA u. e"' . C:.,. (A,.._ CA I,\ .S c. IA DESIGN PROFESSIONAL CONTRACTOR BUS. NAME ADDRESS ADDRESS CITY STATE ZIP CITY STATE ZIP PHONE IFAX PHONE I FAX EMAIL EMAIL I STATE LIC. # STATE LIC.# !CL.ASS I CITY BUS. UC.# (Sec. 7031.5 Business and Professions Code: Any City or County which requires a permit to.construct. alter, improve, demolish or repair any structure, prior to its issuance, also requires the applicant for such per_mlt to file a signed statement tliat he is licensed pursuant to the prov1s1ons of the Contractor's License LawJChapter 9, comme_ndingwith Section 7000 of Division 3 of the Business and Professions Code} or ftlat he is exempt therefrom, and the basis for the alleged exemption. Any violation of Section 031.5 by any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars {$500)). WORKERS' COMPENSATION Workers' Compensation Declaration: I hereby affirm under penalty of perjury one of the following declarations: B I have and will maintain a certificate of consent to self-Insure for workers' compensation as provided by Section 3700 of the Labor Code, for the performance of the work for which this pennit is issued. I have and will maintain workers' compensation, as required by Section 3700 of the Labor Code, for the perfonnance of the work for which this pennil is issued. My workers' compensation insurance carrier and policy number are: Insurance Co. Policy No. ______________ Expiration Date _________ _ ~section need not be completed if the permit is for one hundred dollars ($100) or less, LJ Certificate of Exemption: I certify that in the perfonnance of the work for which this pennit is issued, I shall not employ any person in any manner so as to become subject to the Workers' Compensation Laws of California WARNING: Failure to secure workers' compensation coverage is unlawful, and shall subject an employer to criminal penalties and cl vii fines up to one hundred thousand dollars (&100,000), in addition to the cost of compensation, damages as provided for in Section 3706 of the Labor code, interest and attorney's fees. AS CONTRACTOR SIGNATURE □AGENT DATE OWNER•BUILDER DECLARATION I hereby affirm that I am exempt from Contractor's Ucense Law for the following reason: D I, as owner of the property or my employees with wages as their sole compensation, will do the work and the structure is not intended or offered for sale {Sec. 7044, Business and Professions Code: The Contractor's License Law does not apply to an owner of property who builds or Improves thereon, and who does such work himself or through his own employees, provided that such improvements are not intended or offered for __,_,;ale. If, however, the building or improvement is sold within one year of completion, the owner-builder will have the burden of proving that he did not build or improve for the purpose of sale). ~ I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec. 7044, Business and Professions Code: The Contractor's License Law does not apply to an owner of property who builds or improves thereon, and contracts for such projects with contractor(s) licensed pursuant to the Contractor's License Law) □ I am exempt under Section _____ Business and Professions Code for this reason: rl;,r. 1. I ~lly plan to provide the major labor and materials for construction of the proposed property improvement. OYes ~No 2. l~ave not) signed an application for a building pennil for the proposed work. V\ /J 11, ,. 1 /J !A ( 3. I have contracted with the following person (finn) to pro ide the pro construction (include name address I phone/ contractors' license number): ..JJ /(11 / IV ! \ V v1. r l , ~ 4. I plan to provide portions of the work, but I e hi e following on to coordinate, supervise and provide the major work {include name/ address I phone I contractors' license number): 5. I will provide some of the work, but I have ntract (hired) the ·ng persons to p ide the work indicated (include name/ address/ phone I type of work): .flS PROPERTY OWNER SIGNATURE □AGENT DATE • COMPLETE THIS SECTION FOR NON~RESIDENTIAL BUILDING PERMITS ONLY Is the applicant or future building occupant required to submit a business plan, acutely hazardous materials registration form or risk management and prevention program under SecHons 25505, 25533 or 25534 of the Presley-Tanner Hazardous Substance Account Act? □ Yes □ No ls the applicant or fu!tJre building occupant required to obtain a pennit from the air pollution control district or air quality mancljJement district? D Yes □ No Is the facility to be constructed within 1,000 feet of the outer boundary of a school site? □ Yes O No IF ANY OF THE ANSWERS ARE YES, A FINAL CERTIFICATE OF OCCUPANCY MAY NOT BE ISSUED UNLESS THE APPLICANT HAS MET OR IS MEETING THE REQUIREMENTS OF THE OFFICE OF EMERGENCY SERVICES AND THE AIR POLLUTION CONTROL DISTRICT. I certify that I haYe l8ad the application and state that the above information Is correct and that the infonnatlon on the plans is accurate. I agree to comply'Mth all Cllyordlnanoos and State liMS ralatlng to building construction. I hereby authorize representative of the City of Carlsbad t enter up::m the aOOve mentioned property br inspection p..1rposes. I ALSO A~EE TO SA VE, INDEMNIFY Ni D KEEP HARMLESS THE CllY OF CARLSBAD AGAINST ALL LIABIUTIES, JUDGMENTS, COSTS EXPENSES HICH MAY IN AflYWAY ACCRUE AGAINST &\ID CITY IN CONSEOJENCE OF THE ffiAflTING OF THIS PERMIT. OSHA: AA OSHA pemilt is requred for excavatioos 5'0' mcmx, or construction of structures over 3 stories in height. EXPIRATION: Every permit issued by the Buik:ling · I th visions of this Code shall expire by limitation and oocome null and vokl if the buik:ling or'M)rk authorized by sudl permit is not commenced 'M!hin 100days from the dateofsuch permit or if the bu" g or rk au rized by such permit is suspended or abandoned at any time after the "'°rk is rommenced for a period of 180days (Section 106.4.4 Uniform Buik:ling Code). ,65 APPLICANT'S SIGNATURE DATE "J -2.J-( ( • STOP: THIS SECTION NOT REQUIRED FOR BUILDING PERMIT ISSUANCE. Complete the following ONLY if a Certificate of Occupancy will be requested at final inspection. Fax (760) 602-8560, Email buildinq@carlsbadca.gov or Mail the completed form to City of Carlsbad, Building Division 1635 Faraday Avenue, Carlsbad, California 92008. CO#: (Office Use Only) CONTACT NAME OCCUPANT NAME ADDRESS BUILDING ADDRESS CITY STATE ZIP CITY STATE Carlsbad CA PHONE FAX EMAIL OCCUPANT'S BUS. LIC. No. DELIVERY OPllONS PICK UP: □ CONTACT (Listed above) □ OCCUPANT (Listed above) □ CONTRACTOR (On Pg. 1) MAIL TO: □ CONTACT (Listed above) □ OCCUPANT (Listed above) □ CONTRACTOR (On Pg. 1) MAIL/ FAX TO OTHER: _______________ _ A$ APPLICANT'S SIGNATURE □ ASSOCIATED CB#•------------ □ NO CHANGE IN USE/ NO CONSTRUCTION □ CHANGE OF USE/ NO CONSTIIUCTION DATE ZIP Inspection List Penni!#: CB161165 Type: PME Date __ Inspection_ Item __ 03/2512016 23 GasfTesl/Repairs 03/2512016 29 Final Plumbing Monday, March 28, 2016 4 PLEX-REPAIR GAS LINE FROM THE METER TO THE WATER HEATER Inspector Act Comments AEK AP AEK Fl Page 1 of 1